Time and motion study of patients at the emergency room service of the Vicente Sotto Memorial Medical Center (VSMMC)

Study Design: A descriptive study using time and motion activities of each emergency case at the ER in different departments in three shifts.

Setting: Emergency room of a tertiary government hospital (VSMMC).

Participants: All patients seen at the ER services during the 24 hours duty of the researcher for 5 consecutive duties. Those patients who did not return the numbers assigned to them are considered dropouts and those patients who brought dead or died in the ER are excluded from the study.

Intervention: Colored cardboards were given to patients at the triage area. Each color represents the shifting of duties: green was assigned to morning shift, blue assigned to afternoon shift and yellow assigned to evening shift. As the patients moves through the emergency room, the following information were noted: time patient was seen at the triage area, time patients was seen by a resident physician, time when the residents gave the final disposition of the patients. Time was also noted once the colored cardbords were returned at the triage area.

Main Outcome Measures: Average patient stay in the emergency room, mean waiting ( pre-treatment , treatment and post treatment ) per shift of patients in the emergency room of the Vicente Sotto Memorial Medical Center.

Results: 508 patients were given the colored cardboards for the entire duration of the study. Of these patients, 97 were considered dropouts (19%). Thus, an overall total of 411 patients were actually included in the study. The average patient stay in VSMMC emergency room is 146 minutes. The mean waiting time (pre-treatment) : for department per heft and 9.4 in the evening shift; for the department of Medicine was 7.2 minutes in morning shift, 7.4 in the afternoon shift and 9.4 in the evening shift, for the department of Surgery 6.2 minutes, 8.1 minutes and 11.1 minutes respectively; for the department of Gynecology was 4.0 minutes, 5.8 minutes and 9.5 minutes, for the department of Orthopedics was 9.4 minutes 10.5 minutes and 7.7 minutes. The mean waiting time (treatment/examination): for the department of Internal Medicine was 108.0 for the morning shift, 74.8 for the afternoon shift and 111.8 for the evening shift; for the department of Surgery was 72.1 minutes and 66.8 minutes and 76.2 minutes respectively; for the department of Pediatrics was 120.9 minutes, 112.1 minutes and 119.4 minutes respectively; for the department of Gynecology was 41.5 minutes, 56.0 minutes and 47.7 minutes respectively; for the department of Orthopedics was 38.2 minutes, 44.4 minutes and 33.5 minutes respectively. The mean waiting time (post-treatment): for department of Internal Medicine was 6.0 minutes for the morning shift, 7.8 minutes for the afternoon shift and 6.5 minutes for the evening shift; for the department of Surgery was 6.6 minutes, 6.5 minutes and 7.7 minutes respectively; for the department of Pediatrics was 7.2 minutes, 5.4 minutes and 7.1 minutes respectively; for the department of Gynecology was 7.7 minutes and 5.6 minutes respectively; for the department of Orthopedics was 6.3 minutes, 6.1 minutes and 5.9 minutes respectively.

Conclusion: All the results were consistent with the results of the different studies done in the past. Therefore, the VSMMC ER services is a efficient as other health facilities in terms average waiting time, waiting time pre-treatment and post-treatment. Furthermore, time and motion study of patients is an effective way to assess the efficiency of services in the emergency room and is a good indicator of quality of healthcare being given.